Lebanon: Medical facilities stretched to the limit

July 2013, Tripoli, Lebanon: The waiting room of the Nahada primary health care clinic in northern Lebanon is packed with Lebanese and Syrian patients. The clinic has already seen a 400 per cent increase patients in recent months, many of them Syrian refugees. Credit: OCHA/D.Palanivelu

The waiting room of the Nahada primary health-care clinic in northern Lebanon’s Tripoli region is packed with patients, mostly from Syria. The NGO International Medical Corps (IMC) began supporting the clinic in May to help the increasing number of refugees in the region. But since then, the clinic’s caseload has increased by 400 per cent, and in May its doctors saw about 700 Syrian patients.

There are now over 620,000 Syrian refugees in Lebanon placing a huge strain on the country’s health infrastructure, and aid organizations need to be ready for the situation to worsen, said Colin Lee, the IMC Country Director for Lebanon.

“We're facing many immediate challenges within the health response,” he said. “We all need to prepare for the longer term and the fact that resources will be less readily available."

The World Health Organization says that, based on the current influx of refugees into Lebanon, Syrians’ demands for health-care services will increase by at least 30 per cent over the coming months.

Organizations such as the UN Refugee Agency and IMC are trying to meet these rising needs by supporting clinics and hospitals, and by sending mobile medical units to refugee settlements and villages. But the growing demands, combined with Lebanon’s already high health-care costs and limited funding, mean that this is not enough.

Women and children

“We see a lot of women and children here (at the Nahada clinic),” said Dr. Ibrahim Makdessi, a medical consultant with IMC. “Many pregnant women come here with complications, and there have been premature births because most of them had no pre-natal care in Syria before they arrived.”

Sarah Mohammad, 25, was four months’ pregnant with her first child when she fled Syria one year ago. She knew that if she stayed in Syria, she could not have given birth safely.

“We saw too many people die, and I was crying every day because I was so afraid for my family,” she said.

Like Sarah, many women come to Lebanon to give birth. So far this year, more than 6,000 pregnant women have been admitted to IMC-supported hospitals for deliveries.

At the nearby Tripoli Government Hospital, where doctors have delivered many premature babies, there is growing concern that there are not enough resources to support Syrian and Lebanese families. “There are only eight neo-natal respirators and four of them are being used for Syrian premature babies,” explained Dr. Makdessi.

Water and sanitation

The needs of the growing Syrian refugee community go beyond obstetrics. According to the UN Children’s Fund, UNICEF, many refugee families in Lebanon live in crowded apartments or settlements, and they have little access to clean water, basic toilets and proper waste collection.

At the Nahada clinic, over 30 per cent of the Syrian patients seen in June needed treatment for respiratory diseases, such as pneumonia and bronchitis, caused by pollution and unsanitary conditions. Another 15 per cent suffered from gastrointestinal diseases. The Tripoli hospital recently treated a family of five for severe food poisoning.

“We are seeing many people who are suffering from water and food contamination and Hepatitis A,” said Dr. Makdessi.

Robert Watkins, the Humanitarian Coordinator for Lebanon, agrees that local authorities and humanitarian organizations that are trying to deliver basic services, such as health care, are at risk of being overwhelmed.

“We are concerned that we are not going to be able to meet the needs of the ever-growing refugee population in Lebanon,” added Watkins. “It’s growing at a faster rate than our ability to provide assistance.”

Humanitarian organizations and the Lebanese Government have appealed for US$1.7 billion this year to help refugees and the communities hosting them. About $367 million will go towards health care. Only 15 per cent of the funds have been received so far.